Metformin-Astrafarm 850 mg is a fundamental pharmacological intervention for the management of Type 2 Diabetes Mellitus (T2DM). Belonging to the biguanide class, it serves as a first-line therapy, particularly for patients with excess body weight whose glycemic levels are not adequately controlled by diet and lifestyle modifications alone. By improving insulin sensitivity and reducing hepatic glucose production, Metformin-Astrafarm helps mitigate the long-term macrovascular and microvascular complications associated with chronic hyperglycemia. It is a versatile medication suitable for both monotherapy and combination regimens with insulin or other oral hypoglycemic agents for adults and children aged 10 and older.
Each film-coated tablet is formulated for consistent therapeutic delivery:
Active Substance: Metformin hydrochloride — 850 mg.
Excipients: Povidone, magnesium stearate.
Tablet Coating: Hydroxypropylmethylcellulose 2910, 5sPz, PEG 6000, and titanium dioxide.
Metformin-Astrafarm operates through three primary anti-hyperglycemic mechanisms:
Reduction of Hepatic Glucose Production: It inhibits gluconeogenesis and glycogenolysis, effectively lowering the amount of sugar the liver releases into the blood.
Increased Peripheral Insulin Sensitivity: In skeletal muscle, it improves glucose uptake and utilization by enhancing the efficiency of insulin receptors.
Delay of Intestinal Absorption: It slows the absorption of glucose within the gastrointestinal tract.
Crucially, metformin does not stimulate insulin secretion, which minimizes the risk of hypoglycemia in monotherapy. It also exerts a positive effect on lipid metabolism, often leading to a reduction in total cholesterol, LDL, and triglycerides.
Type 2 Diabetes Mellitus: Specifically in adults and children aged 10 and older when diet and exercise fail.
First-line Therapy: Preferred for overweight patients to reduce diabetes-related complications.
Combination Therapy: Used alongside insulin or other oral antidiabetics for synergistic glycemic control.
Hypersensitivity to metformin hydrochloride or any auxiliary components.
Renal Impairment: Moderate (Stage ІІІb) and severe kidney failure (GFR < 45 ml/min).
Metabolic Crisis: Diabetic ketoacidosis or diabetic precoma.
Acute Conditions: Dehydration, severe infections, or shock.
Tissue Hypoxia: Decompensated heart failure, respiratory failure, or recent myocardial infarction.
Liver Health: Liver failure, acute alcohol poisoning, or chronic alcoholism.
For Adults:
Initial Dose: Usually 500 mg or 850 mg administered 2–3 times daily.
Adjustment: Titrate the dose after 10–15 days based on blood glucose monitoring results.
Maximum Dose: 3000 mg per day, divided into 3 doses.
For Children (10 years and older):
Initial Dose: 500 mg or 850 mg once daily.
Maximum Dose: 2000 mg per day, divided into 2–3 doses.
Timing: Tablets should be taken during or after meals to significantly reduce gastrointestinal discomfort.
Gradual Titration: A slow increase in the dose over several weeks helps the digestive system adapt to the medication.
Gastrointestinal (Very Common): Nausea, vomiting, diarrhea, abdominal pain, and lack of appetite. These are most frequent at the start of treatment and usually resolve spontaneously.
Metabolic: Rare risk of Lactic Acidosis. Long-term use may lead to decreased Vitamin B12 absorption.
Nervous System: Taste disturbances (metallic taste).
Hepatobiliary: Isolated reports of liver function test abnormalities or hepatitis.
Lactic Acidosis: A rare but life-threatening emergency. Risk increases with renal impairment, excessive alcohol intake, and dehydration. Seek immediate hospital care if severe muscle cramps or weakness occur.
Pregnancy: It is generally recommended to switch to insulin during pregnancy to maintain strict glucose control and reduce fetal risk.
Breastfeeding: Use is not recommended as metformin passes into breast milk and safety data is limited.
Driving: Monotherapy does not affect reaction speeds; however, use caution if combined with insulin or sulfonylureas due to potential hypoglycemia.
Store in the original package at temperatures not exceeding 25°C.
Keep in a secure location out of the reach of children.
Shelf Life: 5 years.
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